Dr Dinesh Sirisena

Hi Prednisolone is a steroid. Steroids have many different effects in the body, some good and some negative. In essence, a steroid injection will suppress the local inflammatory response, to help with pain symptoms. Localised injections of steroid (https://sportsmedinfo. sg/treatment/steroid-injections/) tend not to have the same systemic (body-wide) side effects as oral steroids, which include changes to blood sugar, blood pressure, fat distribution in the body, stretch marks, hair thinning, agitation etc.

Hi For OGS there isn't really a supplement to "speed" the recovery and indeed the most important element is correct and careful loading, adequate rest and working with the coaching and management team to achieve this. Sometimes, shockwave therapy CAN help in more serious cases. Here is more information if you are keen: https://sportsmedinfo.

Hi Both work in different ways, Vitamin C tends to provide more generalised improvements in immunity whereas probiotics are more focussed on gut health. Both are useful to maintain your immunity and health.

There may be many different reasons for muscle spasm, however, from a musculoskeletal perspective, it could be due to a problem with: the nerve exiting from the spine, the nerve as it passes through the tissue or from the muscle itself. Irritation of the nerve can result in abberant firing and stimulation of the muscle and hence spasm. If this is suspected, an MRI scan of the spine or nerve conduction tests can be helpful. Sometimes, cramp in the muscle could be due to a change in blood electrolytes or a problem within the muscle itself.

Spacticity is actually ecxessive muscle tone and this is commonly seen in patients after a stroke. Physiotherapists and manual therapists can help with spacticity through release of the tissue while Rehabilitation Medicine phsyicians can help through botox injections into the muscle. If specific muscles are affected, then doing the injection under ultrasound guidance can help. Once the spasticiy is dealt with, it can ease pain significantly but due to the botox, doing exercise to strengthen the muscle will then be quite challenging.

Regarding whether your knee will be amenable to treatment some years after the initial injury, the answer is generally yes, but a repeat assessment will be required to determine what is necessary. For many patients with an ACL or meniscal injury, surgical intervention is not immediately required and rehabilitation can certainly help. If you are having ongoing swelling, instability or locking, or your work/sport is significantly impacted, then seeking help would be advisable. Hope this helps.

In addition to the previous answers, if you are experiencing radicular (along the leg) pain, you might want to disucss a nerve injection for the symptoms. In many centres this is done under CT or flouroscopic guidance, but some places are now offering this under ultrasound guidance. The benefit of the latter is that there is no radition exposure and it is usually considerably cheaper. Hope this helps.

Bowing of the legs can be due to various causes, but off the top it might be due to: Low vitamin D Osteoarthritis of the joint Related to particular sports Long term, there may be a change in your gait, it might cause pain in the knees and ultimately impact your function. In situations where you are concerned, it would be good to consult a MSK/Sports Physician or physiotherapist in the first instance for an assessment, investigations and early treatment. Hope this helps.

The N95 mask is used in high risk areas in the hospital, but for other areas a basic surgical mask provides a barrier. For the general public, it is only really recommended if you are unwell. Apart from a mask, general hygiene and hand washing form the cornerstone of protecting yourself. Hope this helps.

This is quite a challening question to answer without further information. You see, it depends on What was the mechanism of injury? What was the injury? What was the operation? Does the patient have any other concurrent medical issues? Did the patient attend follow-up or rehabilitation? If you are having chronic pain following your operation, it would be best to consult your treating clinician in the first instance, or if this is not possilbe, obtain a polyclinic referral to your local hospital for a reassessment. I hope this helps.

I would suggest going to see a GP or a dermatologist. The itching could be due to a fungal infection that arose from excessive sweating in the groin. If this has been going on for a long time, then it might need more than just a topical anti-fungal cream. Making sure that you wear appropriate underwear during sport is also important. Apart from that, you should also ensure that you dry the area after bathing.

You need to firstly secure a position within a healthcare system in Singapore, either in private practice or within the public hospital sector. Having done so, you need to get your certication from abroad approved by the Singapore Medical Council. Often this takes 4-6 months and you will need to provide all your qualifications, letters from your previous employers and English translations if your certificates are in another language. Hope this helps.

Tendinopathy is usually diagnosed on your presenting history and clinical examination. Different areas of the body might have subtle nuances in terms of presentation and physical tests, but for most tendinopathies, an ultrasound examination is very helpful when supporting the history and examination findings. Most MSK or Sports Physicians should be able to do this for you and depending on the finding, they will advise on you the apropriate course of action. In chronic tendinopathy, there can be swelling, stiffness and redness around the tendon.

If you have a confirmed subscapularis (SSC) tear, then treatment will depend on the nature, degree and inciting event that cause the tear to occur. If it is a small tear involving only portion of the tendon, then this could improve with conservative management such as physiotherapy or with a PRP injection. In situations where there is a more significant tear, you may require a surgical repair, but this also depends on whether the tear is acute of chronic/degenerative in nature. I would suggest getting this assessed more thoroughly before making any further decisions about your treatment.

Tendinopathy can be challenging to treat but the mainstay of treatment remains rehabilitation with physiotherapists and load management. In situations where this is not helping, then you might be offered Extracorporeal Shock Wave Therapy (ESWT) to help stimulate the tendon to heal itself, or in situations where tearing is noted within the substance, a Platelet-rich plasma (PRP) injection could be considered. Other injection treatments include prolotherapy or high volume tendon stripping. However, all injections, care must be taken to offload the tendon afterward.